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Early repolarization, ST-segment elevation in the absence of conduction abnormalities, or chest pain has been considered as a normal state for more than half a century. Because this ECG pattern predominates among young and fit individuals with slow heart rates, it has been generally viewed as a marker of good health. Most recommendations for standardization and interpretation of the ECG include a statement that the term early repolarization is used to describe a normal QRS-T variant with ST-segment elevation, and most clinicians have for years been considering early repolarization as nonspecific ST elevation, especially in the left precordial leads. After some case reports pointing to an arrhythmogenic potential of early repolarization, a series of case–control studies in 2008 unexpectedly described an apparent overrepresentation of J waves (ie, terminal QRS notching and slurring) in inferolateral leads in patients with idiopathic ventricular fibrillation.1,2 These findings challenged physicians to think again about the belief that this pattern was simply a normal variant and lead to confusion among both professionals and patients. Thereafter, inferolateral QRS notching and slurring, referred to as early repolarization ECG pattern, have also been demonstrated to possess an increased risk of sudden cardiac death and mortality in general population,3–5 and its association with malignant arrhythmias during ischemia seems substantial.6–8 However, the first issue to keep in mind with articles concerning this phenomenon of early repolarization is the fact that …